title: Remifentanil-nitroglycerin combination as an anesthetic support for ex utero intrapartum treatment (EXIT) procedure.
abstract: A 21 year old healthy parturient was diagnosed as having a fetus with micrognathia. She was scheduled for an ex-utero intrapartum treatment (EXIT) procedure. General anesthesia consisted of remifentanil, nitrous oxide, and midazolam. Intravenous nitroglycerin was used for uterine relaxation. This technique offered hemodynamic stability and provided uterine relaxation that may be rapidly terminated. For the fetus, it provided excellent transplacental anesthesia. Supplemental direct fetal anesthesia is recommended to prevent the rapid decline of analgesia/anesthesia that occurs after placental separation.
authors.affiliation: Department of Anesthesiology, Perioperative Medicine, and Pain Treatment, Shaare Zedek Medical Center, Hebrew University, POB 3235, Jerusalem 91031, Israel. aioscovich@gmail.com
authors.forename: Alexander
authors.initials: A
authors.lastname: Ioscovich
authors.forename: Ori
authors.initials: O
authors.lastname: Shen
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Sichel
authors.forename: Yishay
authors.initials: Y
authors.lastname: Lajos
authors.forename: Dina
authors.initials: D
authors.lastname: Orkin
authors.forename: Reuven
authors.initials: R
authors.lastname: Bromiker
authors.forename: Alexander
authors.initials: A
authors.lastname: Briskin
mesh_terms: D000768:Anesthesia, General / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000379:methods; D018681:Anesthetics, General / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D046128:Fetal Therapies / Q000379:methods; D006801:Humans; D008844:Micrognathism / Q000628:therapy*; D005996:Nitroglycerin / Q000008:administration & dosage* / Q000494:pharmacology; D010880:Piperidines / Q000008:administration & dosage*; D011247:Pregnancy; D000077208:Remifentanil; D014599:Uterus / Q000187:drug effects / Q000378:metabolism; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000494:pharmacology; D055815:Young Adult
chemical_list: D018681:Anesthetics, General; D010880:Piperidines; D014665:Vasodilator Agents; D005996:Nitroglycerin; D000077208:Remifentanil